AEGiS-13IAC: Declining HIV prevalence and high risk behaviour in Zambia: evidence from national surveillance and population-based surveys.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Declining HIV prevalence and high risk behaviour in Zambia: evidence from national surveillance and population-based surveys.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. ThOrC720)

Fylkesnes K, Musonda RM, Sichone M, Ndhlovu Z, Monze M, Tembo F, Phiri S, Malamba C
K. Fylkesnes, University of Troms é , Institute of Community Medicine, Seiersbjerget 11a, 5018 Bergen, Norge, Tel.: +47 553 281 04, E-mail: knut.fylkesnes@ism.uit.no

OBJECTIVES: Examine trends in HIV prevalence and links to change in sexual behaviour in Zambia.

METHODS: The data stem from the core national epidemiological HIV surveillance and research system in Zambia: i) the epidemiological HIV sentinel surveillance at antenatal clinics (ESS) being operative since early 1990s; ii) population-based HIV surveys (PBS) conducted in 1995/96 and 1998/99. The ESS system was designed to pick the main geographical patterns, whereas the geographical coverage of the PBS was restricted to two sentinel areas allowing epidemiological and behavioural assessments concomitantly.

RESULTS: The ESS data showed a dominant trend of declining HIV prevalence in the age-group 15-19 years in most urban and rural sites the last 5 years, but revealed no consistent pattern of change in the overall prevalence. Among women in the general population, however, the HIV prevalence tended to decline within most age-groups. In both types of data different HIV prevalence trends appeared across educational level strata, i.e. prominent declines associated with higher educational background, whereas stable or rising prevalence associated with low education. The behavioural data revealed a consistent pattern of declining high-risk behaviour in the urban population.

CONCLUSION: The data suggested a dominant trend in the HIV prevalence that corresponds to a substantial decline in the incidence of HIV attributable to favourable changes in behaviour. EES-based trends tended to underestimate the magnitude of prevalence declines in the general population, i.e. higher educational background associates both with high HIV prevalence decline and low fertility rates.

Keywords: AEGIS, Prevalence, HIV, HIV Infections, HIV Seropositivity, Sex Behavior, Incidence, Federal Government, HIV Seroprevalence, Sentinel Surveillance, Urban Population, HIV Antibodies, HIV Seronegativity, Zambia, Human, Female, epidemiology, immunology
000709
ThOrC720